What are the responsibilities and job description for the Compliance Consultant position at Mosaic?
Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.
Mosaic has a wide array of benefits to meet each employee’s individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.
- Compliance Consultant
- Compliance
- Full Time Status
- Day Shift
- Pay: $54,038.40 - $81,057.60 / year
- This position plans, administers, maintains and coordinates compliance processes, policies and procedures as well as applicable laws and regulations for the organization. This position documents regulatory research and guidance, compliance projects, designs and executes risk assessments, develops audits and monitoring techniques to test adherence to policies, procedures, and compliance standards, designs and executes training and education, assists leadership in process improvement to ensure compliance with laws and regulation. Coordinates efforts with Managers of Internal Audit, Information Security and Enrollment.
- This position works under the supervision of the Director of Compliance and is employed by Mosaic Health Systems.
- Reviews a wide variety of organization policies and procedures to ensure compliance with legal, accreditation, and internal standards. Analyzes existing policies, identify gaps and recommend new/revised standards, approval processes, and monitoring methods for departmental use. Review detailed departmental processes and policies noting deficiencies.
- Researches and develops materials for educational programs related to all aspects of compliance, including federal guidelines, and responses to investigations.
- Designs and executes risk assessments to analyze the effectiveness of the Compliance Program, identifying areas for improvement. Develop monitoring plan to determine if the action plan is being adhered. Prioritize issues of risk assessments based on level of the organization exposure. Receive quarterly reports on status of risk monitoring and analyze reported results identifying trends and developing corrective action where appropriate.
- Manages the process of investigation and response to issues identified by the Recovery Audit Contractor (RAC), Medicare Administrative Contractor MAC, Zone Program Integrity Contractor (Z-PIC) or Medicaid Integrity Contractor (MIC). Collaborates with Health Information Services, Patient Financial Services, and/or Care Management to monitor and track results and need for Performance Improvement Action Plans. Audits potential issues before they are identified by the regulatory auditors.
- Investigates allegations and facilitates the remediation gaps and escalates possible critical issues to management, administration, and leadership through to resolution, if necessary. Prepares written narrative of findings, assigns and assesses action plans, and follows up to ensure compliance to agree to actions.
- Other duties as assigned
- All required education is a minimum requirement. Higher levels of education are acceptable. Bachelor's degree from an accredited college or university or an equivalent combination of education and/or experience required.
- CPC and/or CCSP - Certified Professional Coder, RHIT - Registered Health Information Technician or RHIA - Registered Health Information Administrator preferred within 1 year of hire.
- 5 Years coding/billing experience in health care industry, with specific experience typically obtained as a coder, consultant, and/or auditor and proficiency in Microsoft Word, Excel, Access and Power Point required. Prior experience performing physician coding audits or experience working with physicians to correct coding and documentation issues with demonstrated success preferred.
Salary : $54,038 - $81,058
